Waxing Form
Description
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First Name *
Last Name *
Phone number *
Email *
Date of birth *
Street Address *
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Have you used and Alpha Hydroxy Acid (AHA)or glycolic products in the past 48 hrs?
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Are you using Retin-A, Renova or Accutane?
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Are you exposed to the sun or plan on spending more time in the sun soon?
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Do you use a tanning bed?
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Please list you current medications.
Are you currently being treated by a medical professional for any illness or condition?
Have you ever had any reactions or sensitivities to waxing in the past?  If so, please explain.
How did you hear about us?
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